There was also evidence of lower toxicity, for example, a significantly reduced risk of grade 3–4 adverse events reported in one study (OR=0.11). Other studies cited lower rates of adverse events such as nausea, neutropenia and anaemia.

"Given the low toxicity associated with NET, reconsideration of NET as a worthwhile treatment option in the neoadjuvant setting is reasonable, particularly as combination therapy, similar to [neoadjuvant chemotherapy] in combination, for the correct patient population", the authors conclude in JAMA Oncology.
But they emphasize: "Determining the correct patient population for NET remains an unanswered question, and will be best addressed by additional studies incorporating NET with strong biomarker–driven hypotheses.

“Neoadjuvant endocrine therapy also provides the opportunity to examine mechanisms of endocrine resistance, to optimize and compare endocrine therapies, and to investigate combination approaches with novel targeted therapies that may delay or prevent endocrine resistance.”